<!DOCTYPE html>
<html lang="zh-cn">
<head>
    <meta charset="UTF-8">
    <title>商家入驻</title>
    <link rel="stylesheet" href="../themes/omused/pc/resources/amaze-full/css/amazeui.custom.min.css">
    <link rel="stylesheet" href="../themes/omused/pc/resources/css/assess.css">
</head>
<body>
    <div class="ginjog">
        <div class="public-top_enter">
            <div class="block">
                <a href="" class="logo-img"><img src="../themes/omused/pc/resources/images//logo1.jpg"></a>
                <div class="nav">
                    <a href="/">网站首页</a><i>|</i>
                    <a href="#">客户服务</a><i>|</i>
                    <a href="#">网站导航</a>
                </div>

            </div>
        </div>
        <div class="enter-box ">
            <div class="block box">
                <div class="top">
                    <div class="item">
                        <span><img src="../themes/omused/pc/resources/images//icon/icon_enter.png"></span>
                        <p class="fc4594fd">填写个人信息</p>
                    </div>
                    <div class="item">
                        <span>2</span>
                        <p>填写商家信息</p>
                    </div>
                    <div class="item">
                        <span>3</span>
                        <p>商家资质认证</p>
                    </div>
                    <div class="item">
                        <span>4</span>
                        <p>入驻审核</p>
                    </div>
                </div>
                <div class="enter_1-box">
               <form class="am-form am-form-horizontal" role="form">
                        <div class="am-form-group">
                            <label for="doc-ipt-1" class="am-form-label"><i>*</i>交易基地：</label>
                            <select data-am-selected id="jidilist" name="jidi"></select>
                           
                            <script type="text/html" id="jidilisttpl">
                                 <% for (var i = 0 ; i < data.rows.length; i++) { %>
                                <option value="<%=data.rows[i].baseId%>"><%=data.rows[i].baseName%></option>
                                <%}%>
                            </script>
                        </div>
                        <div class="am-form-group">
                            <label for="doc-ipt-1" class="am-form-label"><i>*</i>联系人姓名：</label>
                            <input type="txt" class="am-form-field" id="doc-ipt-1" name="name">
                        </div>
                        <div class="am-form-group">
                            <label for="doc-ipt-1" class="am-form-label"><i>*</i>联系人电话：</label>
                            <input type="txt" class="am-form-field" id="doc-ipt-1" name="phone">
                            <span class="auth-btn">获取验证码</span>
                            <input class="ipt-padding" type="text" id="code" name="kaptcha" value=""
                                   placeholder="请输入验证码"/>

                            <div class="verification-code pos-absolute">
                                <img class="fl" alt="验证码" src="/images/kaptcha.jpg" title="点击更换"
                                     id="img_captcha" onclick="javascript:refreshCaptcha();">
                                <a class="fl" href="javascript:void(0)" onclick="javascript:refreshCaptcha()">刷
                                    新<#--<img src="${ctx}/static/img/refresh.png">--></a>
                            </div>
                        </div>
                        <div class="am-form-group">
                            <label for="doc-ipt-1" class="am-form-label"><i>*</i>手机验证码：</label>
                            <input type="txt" class="am-form-field ph-input" id="doc-ipt-1" name="coder">
                        </div>
                        <div class="am-form-group">
                            <label for="doc-ipt-1" class="am-form-label"><i>*</i>电子邮箱：</label>
                            <input type="txt" class="am-form-field" id="doc-ipt-1">
                        </div>
                        <div class="btn-box">
                            <span class="btn" id="next">下一步</span>
                        </div>
                    </form>
                </div>
            </div>
        </div>
        <div class="public-bottom_enter">
            <p><span>服务热线：400-119-9999</span><span>电子邮箱：mail@auman.com</span></p>
            <p>©2015-2025 欧曼二手机网上交易平台版权所有，Tel：12874028478 您是当前第 100001 位浏览者</p>
        </div>
    </div>
    <div class="am-modal am-modal-no-btn" tabindex="-1" id="pop-modal">
      <div class="am-modal-dialog">
        <div class="am-modal-bd">
        </div>
      </div>
    </div>
<script src="/themes/omused/pc/resources/js/script.js"></script>

<script src="../themes/omused/pc/resources/js/shops_settled.js"></script>
<script>
function refreshCaptcha() {
document.getElementById("img_captcha").src = "/images/kaptcha.jpg?t=" + Math.random();
}
</script>
</body>
</html>